How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $107.15 Median $144.54 Typical High $275.42 | Facility | None | $107.15 | $144.54 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $275.42 | Professional | None | $107.15 | $131.83 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | None | $128.82 | $158.49 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $436.52 | Professional | None | $125.89 | $158.49 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $288.40 | Professional | None | $158.49 | $165.96 | $288.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $263.03 | Professional | None | $151.36 | $165.96 | $263.03 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $218.78 | Professional | None | $147.91 | $169.82 | $218.78 |
SummaCare Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
United Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $281.84 | Professional | None | $117.49 | $173.78 | $281.84 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $144.54 | Facility | 52 · Reduced service | $72.44 | $72.44 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $43.65 | Facility | 55 · Aftercare only | $21.38 | $21.38 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $28.84 | Facility | 56 · Pre-op care only | $14.45 | $14.45 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $173.78 | Professional | 52 · Reduced service | $72.44 | $72.44 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $52.48 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $34.67 |
Where Ohio sits
The same service costs 2.1 times more in Oregon than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 45th of 51
$158
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.